Audat Ziad M, Darwish Fayeq T, Al Barbarawi Moh'd M, Obaidat Moatasem M, Haddad Walid H, Bashaireh Khaldoon M, Al-Aboosy Ihsan A
Department of Neuroscience/Division of Neurosurgery, Level 7A, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid-Amman Street, P,O,box 3030, Irbid, Jordan.
Scoliosis. 2011 Jul 28;6(1):14. doi: 10.1186/1748-7161-6-14.
spondylolisthesis is a condition in which a vertebra slips out of the proper position onto the bone below it as a result of pars interarticularis defect. The slipped segment produces abnormal positioning of the vertebrae in relation to each other along the spinal column and causes mechanical back pain and neural breach.
A randomized and double blinded study consisted of 41 patients aged 36-69 years (18 females and 28 males) treated for symptomatic spondylolisthesis between December,2006 and December, 2009. All patients were randomly distributed into two groups I and II. Twenty patients were in Group I; they underwent reduction of the slipped vertebrae by using Reduction-Screw Technique and posterior lumbar interbody fixation (PLIF). Group II consisted of twenty one patients who underwent only surgical fixation (PLIF) without reduction. All patients in this study had same pre and post operative management.
only one case had broken rod in group I that required revision. Superficial wound infection was experienced in two patients and one patient, from group II, developed wound hematoma. The outcome in both groups was variable on the short term but was almost the same on the long term follow up.
surgical management of symptomatic low grade spondylolisthesis should include neural decompression and surgical fixation. Reduction of slipped vertebral bodies is unnecessary as the ultimate outcome will be likely similar.
腰椎滑脱是一种由于椎弓根峡部裂导致椎体滑出至其下方椎体正常位置之外的病症。滑脱节段会导致脊柱中椎体间出现异常的位置关系，进而引起机械性背痛和神经损伤。
一项随机双盲研究纳入了2006年12月至2009年12月间接受治疗的41例有症状的腰椎滑脱患者，年龄在36 - 69岁之间（18名女性和28名男性）。所有患者被随机分为I组和II组。I组有20名患者，他们采用复位螺钉技术和后路腰椎椎间融合术（PLIF）对滑脱椎体进行复位。II组有21名患者，他们仅接受了手术固定（PLIF）而未进行复位。本研究中的所有患者术前和术后管理相同。
I组仅有1例出现棒材断裂，需要翻修。有2例患者发生了浅表伤口感染，II组有1例患者出现伤口血肿。两组的短期结果各不相同，但长期随访结果几乎相同。
有症状的低度腰椎滑脱的手术治疗应包括神经减压和手术固定。由于最终结果可能相似，因此没有必要对滑脱椎体进行复位。
